oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Jonathan E. Rhoads lecture 2011: insulin resistance and enhanced recovery after surgery
Örebro University, School of Medicine, Örebro University, Sweden.ORCID iD: 0000-0003-2636-4745
2012 (English)In: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444, Vol. 36, no 4, p. 389-398Article in journal (Refereed) Published
Abstract [en]

This lecture reviews the current understanding of how insulin resistance, as a marker of the metabolic stress, is involved in recovery after major surgery. Insulin resistance develops as a graded response related to the magnitude of the operation. It lasts for weeks after medium-size surgery and affects all parts of body metabolism. Although hyperglycemia develops, muscle and fat uptake is reduced and other non-insulin-sensitive cells have an increase in glucose uptake as a result of the elevated glucose levels. Reduced glucose uptake and storage in muscle along with loss of lean body mass help explain reduced muscle function that will impair mobilization. The increased uptake of glucose in non-insulin-sensitive cells is involved in the development of several of the most common postoperative complications, including infections and cardiovascular problems. Many of the perioperative treatments in use are outdated, and modern care involves a multimodal approach with several treatments, such as preoperative carbohydrate treatment instead of overnight fasting, continuous epidural anesthesia for postoperative pain care, early feeding, and mobilization, all of which affect insulin by reducing the stress and enhancing recovery. Most of the previous mandatory catabolic responses to surgery can be avoided, resulting in substantially faster recovery and fewer complications. Methods to implement these modern treatments have been developed and used in Europe, resulting in improved care and shorter length of stay.

Place, publisher, year, edition, pages
Sage Publications, 2012. Vol. 36, no 4, p. 389-398
Keywords [en]
enhanced recovery; insulin resistance; postoperative nutrition; preoperative carbohydrates; surgery
National Category
Nutrition and Dietetics
Research subject
Nutrition
Identifiers
URN: urn:nbn:se:oru:diva-26022DOI: 10.1177/0148607112445580ISI: 000305487500005PubMedID: 22577121Scopus ID: 2-s2.0-84862880593OAI: oai:DiVA.org:oru-26022DiVA, id: diva2:556792
Funder
Swedish Research Council
Note

Funding Agencies:

Söderberg Foundation

Stockholm City Council

Karolinska Insitutet

Nutricia Research

Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2017-12-07Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Ljungqvist, Olle

Search in DiVA

By author/editor
Ljungqvist, Olle
By organisation
School of Medicine, Örebro University, Sweden
In the same journal
JPEN - Journal of Parenteral and Enteral Nutrition
Nutrition and Dietetics

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 474 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf